Most people will at one point or another experience tooth decay that eventually leads to a cavity. To the average person, cavities are small annoyances that a dental professional can easily correct by removing the cavity and replacing the decay with some type of dental filling. Some individuals, however, experience tooth decay more than others. In particular, a portion of the population deals with rampant cavities that are difficult to contain and control.
Recent advances in dental science have helped dental professionals to more fully understand the causes of tooth decay and cavities. Many studies suggest that a person's diet may drastically affect the chances of getting a cavity. In particular, many experts argue that diets high in carbohydrates and other sugars, and lower in meat and whole grains, cause an increased risk of cavities. For example, studies have suggested that diets high in carbohydrates may cause oral micro-flora to become imbalanced, which may lead to increases risk of tooth decay, and ultimately an increased risk of cavities.
Modern microorganism studies have confirmed that the main bacterial culprits of tooth decay do indeed feed on carbohydrates, and other sugars that make up the building blocks of carbohydrates. Studies have also shown that of all the bacterial culprits responsible for tooth decay, the bacterium known as Streptococcus mutans is the bacterium with the most influence on causing tooth decay.
Streptococcus mutans depends entirely upon human hosts for its survival and progresses through a standard cycle of events with its host. The cycle begins with inoculation of an infant soon after birth by parental contact. Streptococcus mutans can be transmitted through saliva and is highly contagious. In order for Streptococcus mutans to become a permanent resident in the oral environment, the bacterium must attach somewhere in the oral cavity. By attaching to a site within the oral cavity, the Streptococcus mutans may colonize and avoid being washed to the stomach by saliva. Unfortunately, the human oral environment provides ample attachment sites for Streptococcus mutans as there are various crevasses to inhabit such as the gingival margin, spaces between teeth, etc.
After the Streptococcus mutans finds an attachment site, the process of tooth decay begins. The process begins when Streptococcus mutans consume sugar and excrete lactic acid as a waste product. As is well known, tooth enamel is composed entirely of mineral rods of calcium hydroxyapatite, which is susceptible to dissolution in acidic environments. The residual food that remains lodged in the oral cavity after eating provides the nutrient source for Streptococcus mutans to digest, which therefore produces the lactic acid that eventually dissolves holes in the enamel.
Once the lactic acid has produced holes in the teeth the decay process intensifies because the holes create even more protected space for food and the Streptococcus mutans to occupy. The rate at which the Streptococcus mutans digests carbohydrates and produce lactic acid can exponentially increase, causing tooth decay to exponentially increase, which can lead to a cavity in a fairly short amount of time.
Providing quality oral hygiene in the fight against cavities requires a direct understanding and plan to deal with the lactic acid produced from the Streptococcus mutans. The most common prevention method today is brushing the teeth with a fluoride dentifrice (tooth paste). First, the toothbrush allows a person to remove the excess food after he or she eats, and thereby deprive the Streptococcus mutans of an available nutrient source. Second, the toothbrush stirs up or aggravates the bacteria and dislodges it from attachment sites, thereby impeding colony progression and growth.
As far as the toothpaste's function, the toothpaste's primary function is to deliver a dose of fluoride to tooth enamel Fluoride may chemically change the calcium hydroxyapatite of tooth enamel into a more acid resistant composition of calcium fluoroapatite. The process of fluoroapatite synthesis takes advantage of the electronegative reactivity of the fluoride ion during the natural re-mineralization cycles between the tooth and saliva, causing the tooth enamel to be more resistant to acid environments.
Although brushing the teeth helps fight tooth decay, toothbrushes and toothpaste are purely preventative measures and do nothing to address the eradication of the Streptococcus mutans. The eradication of the offending microorganisms was at one time thought to be the ultimate end of restorative dentistry. Research eventually produced the antibiotic “tetracycline” that was intended to wipe out tooth decay from the human race once and for all. This project ended in abysmal failure; instead, tetracycline treatment resulted in tetracycline resistant Streptococcus mutans, with the children of these patients being stricken with brown to green mottled teeth. It is now generally understood that microorganisms are very adaptable and usually evolve faster than antibiotics can be produced.
The foregoing leaves the toothbrush and fluoride as the essential means to combat tooth decay. The toothbrush and toothpaste, however, have disadvantages that decrease their effectiveness in the overall prevention of tooth decay. The biggest disadvantage is patient compliance. For example, most people brush twice a day and it is usually before breakfast and after dinner. The most effective time to brush is after eating to immediately remove any food left behind in the oral cavity. Moreover, the average person brushes less than 60 seconds at a time. In order for the fluoride in the toothpaste to have any positive effect, a person must brush for at least 60 seconds or longer.
There are several reasons that most people to not brush properly. For example, brushing teeth is not always convenient. To brush after every meal a person would have to deal with the annoyance of carrying a toothbrush and toothpaste during the day. Additionally, the person would have to find a convenient place to brush his or her teeth, which is another annoyance. Finally, after brushing a patient has to deal with a wet toothbrush and where to store it. In contemporary lifestyles the toothbrush and toothpaste are consigned for home use because that is the time and location when a person can most easily and conveniently brush their teeth and store the toothbrush and toothpaste.
As indicated above, the time when most people brush their teeth is the least effective time to brush teeth. In particular, the largest variances in oral pH happen after each meal corresponding with the cycle of sugar consumption by the Streptococcus mutans into lactic acid. In the early 20th century many studies were completed measuring the oral pH of patients as it relates to time and events. The general conclusions from these studies give us a better understanding of the oral environment. The general conclusions are as follows:                a. The average pH of oral saliva varies between individuals, yet the average pH of an individual stays fairly constant. The pH of some individuals within a group may differ in range from as wide as 5 to 8, yet the pH of each individual within the group would remain fairly repetitive. This conclusion may explain why some people have such a large problem with getting cavities, while others do not.        b. The largest drop in pH of saliva happens after eating, followed by a slow rise in pH. The average pH drop of oral saliva after eating is between about 0.5-1.0 in healthy patients. The change in pH spikes at about 15-20 minutes after eating, followed by a gradual rise back to normal levels in about 60 minutes.        
Among other conclusions, these studies indicated that the pH level of saliva was a major factor in tooth decay of an individual. The more acidic the saliva, the greater risk of tooth decay.
In addition, studies have also shown that it is not the pH levels of the saliva alone that cause cavities. An additional factor that can affect the rate at which dental caries occur concerns the buffering capacity of the salvia. Buffering capacity relates to the ability of a buffer—e.g., a partially neutralized acid—to resist changes in pH. Salts such as sodium citrate or sodium lactate are common buffers used to partially neutralize an acid. In patients that tend not to easily get cavities, their saliva is usually shown to have an increased buffering capacity.
In sum, clinical studies have shown that the greatest correlating cause of tooth decay between patients is the pH and the buffering capacity of their saliva. In order to adequately address prevention of tooth decay, both the pH and buffering capacity of saliva must be controlled. Some conventional products have been developed to attempt to address the pH issue of saliva. For example, conventional products that contain ingredients such as sorbitol, xylitol and other sugar free sweeteners claim to be helpful in restoring pH levels after a meal. These conventional products, however, do not chemically modify the saliva, but rather simply increase and stimulate natural saliva flows after a meal. Although increasing the saliva flow is more beneficial than doing nothing, the rate at which the pH level within the saliva is normalized is slow, which may still allow tooth decay.
What is needed is a dental treatment which quickly and efficiently adjusts pH levels within the oral cavity, increases the buffering capacity of salvia, avoids side effects, and provides a product suitable for simple patient compliance.